| Study type/ Setting | Methods | Outcomes | Recommendations | Source |
| Prospective intervention design
Setting: Outpatient
|
- PharmaCloud is a new technical platform adopted by the National Health Insurance Administration of Taiwan to collect patients’ medical information via cloud technology - The system provides instant access to detailed cloud-based pharmacy claims data from different healthcare facilities for the past 3 months with a lag time of 2 days; it enables healthcare providers to obtain a patient’s medication information via a secured internet portal - Patients were assigned to the PharmaCloud group and the non-PharmaCloud group in the outpatient setting, and then compared their medication usage and expenditure | - After the application of PharmaCloud, the average number of prescribed drug items significantly decreased.
- Intra-hospital medication duplication rates also decreased. |
- The implementation of cloud technology improved patient medication safety while also controlling overall drug expenditure. | Liao C-Y et al. (2019) |
| Liao C-Y, Wu M-F, Poon S-K, et al. Improving medication safety by cloud technology: Progression and value-added applications in Taiwan. International Journal of Medical Informatics. 2019;126:65-71. doi:10.1016/j.ijmedinf.2019.03.012 |
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2019
Role of pharmacist led home medication review in community setting and the preparation of medication list.
Posted on by Ryan J Tran
| Study type/ Setting | Methods | Outcomes | Recommendations | Source |
| Cross sectional interventional study
Setting: Community
|
- The study was conducted to identify, prevent and resolve potential medication-related problems, optimize pharmacotherapy and
assist in achieving better health outcomes for patients at home through Home Medicines Review (HMR) - HMR is a patient-focused, meticulous and collaborative health care service provided by pharmacists in the community setting. - Study was conducted for a period of 6 months in 85 patients where discrepancies of the prescriptions, knowledge gap of the patients, use of other medication and storage conditions of medicines were evaluated |
- The patient had a lack of knowledge in factors like the name of the drug (34%), the reason for taking the medication (27%), etc.
- Drug interaction was a primary concern main discrepancy found in majority of the prescriptions. - Around 32% of the population experienced ADR on taking the medication and among the patients interviewed, 64% of them didn’t use any OTC drugs along with prescribed drugs. - Around 60 of the interviewed patients stored multiple drugs in a same container and 52 of the patient’s medicines had illegible labels. |
- Qualified pharmacists can play a major role in improving the appropriateness of prescribing, preventing medication related adverse events. | Chandrasekhar D et al. (2019)
|
| Chandrasekhar D, Joseph E, Ghaffoor FA, Thomas HM. Role of pharmacist led home medication review in community setting and the preparation of medication list. Clinical Epidemiology and Global Health. 2019;7(1):66-70. doi:10.1016/j.cegh.2018.01.002 |
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Medication Reconciliation Across Care Transitions in the Pediatric Medical Home.
Posted on by Ryan J Tran
| Study type/ Setting | Methods | Outcomes | Recommendations | Source |
| Retrospective evaluation
Setting: Pediatric primary medical care
|
This was a retrospective evaluation of a medication reconciliation across care transitions (MRAT) program developed and piloted for one year in an academic pediatric primary care medical home. The MRAT involved chart review and contacting caregivers upon receiving external specialist notes or hospital discharge summaries. Data obtained from the program were used to determine the frequency and types of medication discrepancies for children with complex and noncomplex chronic conditions. | MRATs for 124 encounters were evaluated,
74.0% in response to specialist appointments. Chart review revealed a mean of 3.64 discrepancies per patient, and telephone calls revealed 1.39 additional discrepancies per patient. The number of medication discrepancies from both chart review and telephone calls between complex and noncomplex patients was statistically significant, with a mean of 5.63 vs. 3.77 per patient (p = 0.005). Therapy delays occurred in 16.1% of patients due to insurance rejections, family not starting a new medicine, or confusion about the medication change. Mean time required for reconciliation was 24 minutes. In addition to medication reconciliation, 107 interventions completed during MRATs included patient education, adjusting drug therapy, coordinating care between providers, recommending laboratory monitoring, and facilitating patient appointments |
Children are more prone to medication changes during hospitalization. Timely identification of changes improves patient safety. | Condren M
et al 2019
|
| Condren M, Bowling S, Hall B, Woslager M, Shipman A, Mcintosh H. Medication Reconciliation Across Care Transitions in the Pediatric Medical Home. The Joint Commission Journal on Quality and Patient Safety. 2019. doi:10.1016/j.jcjq.2019.01.003 |
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Technician Medication Reconciliation in Primary Care Is An Overlooked Opportunity
Posted on by Ryan J Tran
| A pilot program; retrospective chart review
Setting: Primary care |
- Boise VA Medical Center - A program aimed to evaluate a pharmacy technician-directed medication reconciliation process in the primary care setting from Feb 2015 - April 2015
- Following completion of the pharmacy techdirected MR pilot, a retrospective chart review was done to identify the number of resolved discrepancies |
- The pharmacy technician had identified 837 discrepancies, 712 of which were considered to be of minor clinical significance and unlikely to affect patient safety and 109
of which were of moderate clinical significance |
- The pharmacy technician–directed MR process helped avoid a number of errors, improved patient care, and ultimately decreased cost to the health care system.
- These experiences highlight the opportunities available to technicians to improve the accuracy and completeness of MR in the primary care setting. |
Bolster and Koyle (2019) |
| Pharmacytimes.com. (2019). Technician Medication Reconciliation in Primary Care Is an Overlooked Opportunity. [online] Available at: https://www.pharmacytimes.com/publications/issue/2019/january2019/technician-medication-reconciliation-in-primary-care-is-an-overlooked-opportunity [Accessed 27 May 2019]. |
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